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Changing trach ties


Important: You must not change your child’s trach ties alone.You must have another person hold the tracheostomy (trach) tube in place while you change the ties.

You should change your child’s trach ties at least one (1) time each day. You should also change them when they are:

  • Wet,
  • Dirty,
  • Loose,
  • Too tight, causing too much pressure on your child’s skin, or
  • When you change the trach tube.

How to change trach ties

  • Wash your hands with soap and water. Dry them well. See “Do you know…Clean hands.
  • Gather your supplies in a clean work area. You will need the items listed below. The picture shows items 1–3.
Supplies for changing ties
  1. Blunt-tipped scissors
  2. Trach ties
  3. Rolled towel or small blanket roll if needed.
  4. Second caregiver who has learned how to care for a trach at home. A nurse must train this person to do trach care.
  5. Non-sterile gloves (optional)
  6. Trach tie pattern
Put a towel under the neck


  • Place the rolled towel or blanket roll under your child’s shoulders. This makes it easier to see the trach area and reach around your child’s neck. (See photo at left.)


  • Measure how long the ties need to be by holding them around your child’s neck. Or use a trach tie pattern (see photo at right).
Measure for trach ties
Cut trach ties to fit


  • Put on non-sterile gloves (optional).
  • Cut off any extra length before putting the trach ties around your child’s neck (see photo at left).
  • Place the new trach ties behind your child’s neck.
  • Have your helper hold the trach tube in the stoma while you change the trach ties (see photo at right).
  • Remove the old trach ties.
Change ties
Thread the fastener



  • Thread the long, narrow fastener tab through the openings on each side of the trach tube. (See photo at left.)
  • Fasten each of the Velcro® fastener tabs.
  • Put on new trach ties. Adjust the neckband so it is not too tight or too loose. You should be able to get one (1) finger under the neckband. (See photo at right.)
  • Fasten the wide Velcro® fastener tab to the soft material on the main band. Press firmly to keep it in place.You should tell your helper that the ties are secure and the right length before the helper lets go of the trach.
Adjust the neckband


If you have questions or concerns about changing the trach ties, talk to your child’s clinical nurse specialist. A nursing coordinator is always here to answer your questions and address your concerns. Call 901-595-3300 and ask for the nursing coordinator. If you are outside the Memphis area, dial toll-free 1-866-2STJUDE (1-866-278-5833), and press 0 when the call connects.


This document is not intended to take the place of the care and attention of your personal physician or other professional medical services. Our aim is to promote active participation in your care and treatment by providing information and education. Questions about individual health concerns or specific treatment options should be discussed with your physician.

St. Jude complies with health care-related federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

ATTENTION: If you speak another language, assistance services, free of charge, are available to you. Call 1-866-278-5833 (TTY: 1-901-595-1040).

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-278-5833 (TTY: 1-901-595-1040).

تنبيه: إذا كنت تتحدث باللغة العربية فيمكنك الاستعانة بخدمات المساعدة اللغوية المتوفرة لك مجانا. .يرجى الاتصال بالرقم. 5833-278-866-1  (الهاتف النصي: 1040-595-901-1).